Monday, February 9, 2009 at 11:44AM | in World Development Does 'improved' sanitation make children healthier?
Not always. That's the conclusion of a brilliant young researcher at the Oxford University-based Young Lives Project:In response to pressure to reach the Millennium Development Goal of improved sanitation access, the Ethiopian government has developed an ambitious plan to achieve 100 per cent access to pit latrines by 2012. The plans to achieve this target rely upon the assumption that universal access to pit latrines will lead to improved health outcomes. Using the Young Lives pro-poor longitudinal data of Ethiopian children, this research uses propensity score matching to test this assumption. Children who experienced a change from no toilet to a household pit latrine between rounds of data collection were compared to those who continue to use a forest/field. The findings show that there is no significant difference between groups in terms of health outcomes and that a pit latrine does not necessarily signal improved methods of waste disposal. Individual and group interviews conducted by Young Lives suggest that poor infrastructure and care for pit latrines deter children from using such facilities and promote a preference for the use of other methods of waste disposal. Policy makers should note that simply increasing access to pit latrines will not necessarily promote better health outcomes, especially when 'improved' sanitation appears to be less clean than other available options.
The findings of this research pose difficult questions for policy-makers:
The challenge to countries as they attempt to respond to the international target for environmental stability places communities at risk of developing a poor quality infrastructure that will not, in the end, respond to the central issue of the public health risks related to poor sanitation. When rising to meet the goals set forward by the international community, is quality better than quantity? Is it worth settling for suboptimal solutions in the short-term?
Anybody acquainted with health care inqualities in the world understands the unacceptable conditions faced by millions of children. Do we really need to choose betwen quality and quantity?
Monday, February 9, 2009 at 11:44AM | in World Development 
Reader Comments (5)
I think your post is a little biased.
To the contrary. I know the author very well!
... yes where is the "full disclosure" on this one? ;-)
(Even if we're biased), the author makes an excellent point and it can be extended to other similar development projects. We tend to think that 'building something' will solve a problem (ex. latrines, schools, hospitals), when in fact it is the human development that is critical (ie. training community health educators, dedicated teachers, and health workers). So is there a better alternative to building more pit latrines?
As I see it, the point could be made that physical/material solutions might be more effective if they went hand-in-hand with spiritual (good character) and intellectual development.
Another case in point is the continued decline in successfully educated students where I live- even though more money has been spent on education.
If "normalcy" can be described as a balanced, progressive life, then the deficient areas need to be identified correctly before the remedies are prescribed- and then monitored to see if they are correct or need modification.
Beloved Camerons, I had a feeling I'd recognise the name when clicking through to discover the identity of said 'brilliant young researcher'. Lo, I was right. As no doubt is Geoff!
S.